Lowering your A1c is possible through a combination of dietary changes, exercise, sleep habits, and, when needed, medication. Because A1c reflects your average blood sugar over roughly two to three months, changes won’t show up overnight, but most people see meaningful improvement within one to two testing cycles. The target for most adults with diabetes is an A1c below 7%, while the prediabetes range falls between 5.7% and 6.4%.
What A1c Actually Measures
A1c tracks how much sugar has attached to your red blood cells’ hemoglobin over their lifespan. Glucose binds to hemoglobin gradually, so the longer and higher your blood sugar runs, the more hemoglobin gets “coated.” Red blood cells live an average of about 80 days (not the commonly cited 120, which represents only the longest-surviving cells), so your A1c is essentially a weighted average of your blood sugar over that window, with more recent weeks influencing the number more heavily.
This means anything you do today won’t register on your next A1c test for weeks. Most people need two to three months of consistent changes before they see a stable drop. That delay can feel frustrating, but it also means a single bad week won’t wreck your progress.
Choose Lower Glycemic Foods
The glycemic index (GI) ranks foods by how sharply they raise blood sugar compared to pure glucose. Foods scoring 55 or below cause a slower, gentler rise. Foods above 70 behave almost like straight sugar in your bloodstream. Swapping high-GI staples for lower-GI alternatives is one of the most direct ways to bring down your average blood sugar.
Some practical swaps that make a real difference:
- White rice → brown rice or converted rice
- Instant oatmeal → steel-cut oats
- Cornflakes → bran flakes
- Baked potato → pasta or bulgur
- White bread → whole-grain bread
- Corn → peas or leafy greens
Most fruits, vegetables, beans, nuts, and minimally processed grains fall in the low-GI category. White bread, rice cakes, bagels, and most packaged breakfast cereals land in the high-GI range. You don’t need to memorize a chart. The general rule: the less processed a carbohydrate is, the lower its glycemic impact.
Increase Your Fiber Intake
Fiber slows carbohydrate absorption, which blunts the blood sugar spikes that drive A1c upward. A large meta-analysis in PLOS Medicine found that people with diabetes who increased their daily fiber intake by 15 grams, or reached a total of 35 grams per day, saw meaningful improvements in blood sugar control. That same level of intake was associated with a 35% reduction in the risk of dying from any cause compared to eating just 19 grams per day.
Most people eat far less than 35 grams. Getting there doesn’t require a complete overhaul. Adding a cup of lentils (about 15 grams of fiber), a handful of almonds, an extra serving of vegetables, and choosing whole grains over refined ones can close the gap. Increasing fiber gradually helps avoid bloating and digestive discomfort.
Exercise Lowers A1c Two Different Ways
Aerobic exercise (walking, cycling, swimming) and resistance training (weight lifting, bodyweight exercises) both help, but through slightly different mechanisms. Aerobic activity burns glucose directly during the workout and improves how your cells respond to insulin for hours afterward. Resistance training builds muscle mass, and muscle tissue is one of the body’s primary destinations for blood sugar, so having more of it creates a bigger “sink” for glucose around the clock.
Research in Diabetes Care found that resistance training alone reduced A1c by about 0.6 percentage points over three months in people starting around 8.8%. Combining both types of exercise tends to produce the best results. Current guidelines recommend at least 150 minutes per week of moderate aerobic activity plus two or three sessions of resistance training. Even modest amounts help. If you’re currently sedentary, a daily 20-minute walk is a legitimate starting point.
Sleep and Stress Matter More Than You Think
Poor sleep directly interferes with blood sugar regulation. Research published in Psychoneuroendocrinology found that people with type 2 diabetes who reported greater sleep problems had significantly higher cortisol levels throughout the day. Cortisol triggers the liver to release stored glucose and reduces insulin sensitivity, both of which push blood sugar (and eventually A1c) upward. The study also found that poor sleepers had elevated evening cortisol specifically, a pattern linked to higher cardiovascular risk.
Chronic stress works through the same cortisol pathway. Your body can’t distinguish between a looming work deadline and a physical threat, so it dumps glucose into your bloodstream either way. Prioritizing seven to eight hours of sleep and finding even basic stress-reduction strategies (regular physical activity, consistent daily routines, limiting screen time before bed) can chip away at A1c in ways that diet alone may not.
How Medication Fits In
When lifestyle changes aren’t enough to reach your target, medication closes the gap. The most commonly prescribed first-line drug for type 2 diabetes typically lowers A1c by 1 to 1.5 percentage points. Newer injectable medications called GLP-1 receptor agonists can reduce A1c by an additional 0.6 to 1.6 percentage points on top of other treatments, depending on the individual. These drugs work by helping your body release insulin more effectively after meals and by slowing digestion, which flattens post-meal blood sugar spikes.
Medication isn’t a substitute for lifestyle changes, but it’s not a failure either. Many people need both, and the combination is often more effective than either approach alone.
Tracking Progress With Continuous Monitors
If you use a continuous glucose monitor (CGM), you can get real-time feedback without waiting months for an A1c test. The key metric is “time in range,” meaning the percentage of the day your blood sugar stays between 70 and 180 mg/dL. Spending 70% of your time in that range corresponds to an A1c of roughly 7%. Every additional 10% of time in range (about 2.4 extra hours per day) maps to approximately a 0.6% drop in A1c.
That relationship isn’t perfectly precise for every individual, but it gives you a useful working estimate. If your CGM shows you’re spending only 50% of the day in range, that corresponds to an A1c around 8%, and you can see exactly which meals, activities, or times of day are pulling you out of range. That granularity makes it far easier to identify what to change and whether the change is working, weeks before your next lab draw.
A1c Targets Aren’t One Size Fits All
The standard target of below 7% applies to most nonpregnant adults, but the right goal depends on your situation. People who are otherwise healthy and at low risk of dangerous blood sugar drops may aim for below 6.5%. Older adults with multiple chronic conditions or cognitive impairment often have more relaxed targets, because the risk of blood sugar dropping too low can be more dangerous than running slightly higher.
The 2026 Standards of Care from the American Diabetes Association categorize older adults into three tiers: healthy, complex or intermediate health, and very complex or poor health. For the intermediate group, the recommendation allows blood sugar to run above the ideal range up to 50% of the day if that’s what it takes to prevent hypoglycemia. The priority shifts from hitting a perfect number to avoiding harm. Your target should reflect your overall health, not just your diabetes.